We are able to give you an estimate of fees for the initial, longer consultation, and for the subsequent visits when you make your appointment. All consultation fees should be paid on the day. We accept cash, cheque and credit cards (excluding American Express and Diners). If you desire, we are usually able to process the insurance rebate on your behalf at the time of payment. A current referral from your GP or another doctor is required to claim the Medicare rebate.
We subscribe to the concept of Informed Financial Consent. If surgery is recommended, we will provide you with a quote. This will include an estimate of the surgeon’s fee, assistant’s fee (if applicable), and list any applicable rebates. It will not cover any hospital or anaesthetic fees; these will be billed to you separately and are your responsibility.
It will also not cover any physiotherapy or other therapist fees; this will also be billed separately by the practitioner concerned. Most health funds have provision for therapies.
Some procedures have a number of postoperative reviews incorporated into the fee.
What is the Medicare Benefits Schedule?
The Medicare Benefits Schedule (MBS) is a listing of how much the Federal government thinks any given surgical procedure should cost. The Medicare rebate is then what the government is prepared to pay towards this procedure; currently this amount is 75% of the MBS fee.
Since the development of the MBS in 1985, the schedule has not increased in line with inflation to reflect the increasing costs of health care provision, leading to the development of a ‘gap’.
What is a 'gap'?
A gap is the difference between what the doctor charges and the Medicare rebate. Your health insurer will pay the remaining 25% of the MBS fee; any sum over this is the responsibility of the patient.
What is the AMA Schedule?
The Australian Medical Association (AMA) issues a regularly updated listing of recommended fees for medical services which are calculated taking into consideration the economic burden of providing health care and other circumstances. Generally, the AMA Schedule fee is three times the MBS fee.
What is an Item Number?
An Item Number is a code which identifies a particular medical service or procedure. For example, Total Hip Replacement is identified by the item number '49318'. Some operations involve more than one part, and therefore are associated with more than one item number. When provided with a quote for your operation, the item number(s) will be listed. This information is required by your health insurance provider to calculate the benefit you will receive for this service. The number(s) will also be required by the hospital and other providers of health care services to calculate fees associated with your care.
This information handout has been written by Dr David Shooter for the purposes of patient education. The details provided are of general nature only and do not substitute for professional recommendations based an individual clinical assessment.